Journal of The Egyptian Society of Nephrology and Transplantation最新文献

{"title":"Takayasu arteritis presenting as renal infarction","authors":"M. Abdulla, Rinoy R. Anand","doi":"10.4103/jesnt.jesnt_11_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_11_22","url":null,"abstract":"","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134054170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular access thrombosis among end-stage renal disease patients with acute COVID19 infection (a retrospective cohort study)","authors":"A. Elmahdi, Rasha Gawish, Wael Shalaan, M. Eldin, Nahla Gamal, M. Mabrouk","doi":"10.4103/jesnt.jesnt_39_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_39_21","url":null,"abstract":"Background According to studies, coronavirus disease 2019 (COVID19) infection is linked to an elevated risk of venous thromboembolism (TE). The frequencies of overall COVID19 thrombotic events and the influence of TE on COVID19 mortality, however, are unknown. Although respiratory symptoms are the most common symptom of the disease, evidence is growing suggesting that it is linked to coagulation system malfunction, which puts patients at risk for venous and arterial TE and higher mortality as well. Materials and methods A retrospective cohort study was conducted on 50 end-stage renal disease patients on maintenance hemodialysis (25 patients with confirmed COVID19 infection and 25 patients without COVID19 infection) to determine the incidence of vascular access thrombosis among patients with COVID19 during a 3-month period. Risk factors for mortality and severity were considered as secondary outcomes. Patients with previous history of vascular access dysfunction were excluded from the study. Results In all, 24% of COVID19-positive patients (n=6) developed vascular access thrombosis during 3 months of follow-up while no one of the COVID19-negative patient developed access thrombosis. The incidence of vascular access thrombosis was statistically higher in the COVID19 positive group (p value < 0.022). The incidence of vascular access thrombosis was significantly can u please add this part : increased in patients who had lymphopenia, elevated LDH, also it was more common in patients who needed mechanical ventilation and who had severe diseaseConclusion The incidence of vascular access thrombosis was statistically higher in the COVID19 positive group (p value < 0.022). The incidence of vascular access thrombosis was significantly can u please add this part: increased in patients who had lymphopenia, elevated LDH, also it was more common in patients who needed mechanical ventilation and who had severe disease.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128536589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney biopsy in elderly patients","authors":"G. Vakrani, Nambakam Tanuja","doi":"10.4103/jesnt.jesnt_28_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_28_21","url":null,"abstract":"Background Although there is progressive loss of renal mass and function as age progresses, still newer kidney diseases occur. Kidney diseases in the elderly are different compared with younger population. This is because of more commoner occurrence of secondary kidney diseases than primary kidney diseases compared with younger. There is a paucity of Indian literature regarding kidney biopsy in the elderly. The reasons could be fear of increased risk of complications in the elderly, or attributing all kidney diseases to common comorbidities like diabetes mellitus, hypertension, malignancy, intake of potential nephrotoxic medications, and not subjecting them to kidney biopsy. Thus, performing kidney biopsies and analyzing the biopsy findings is not only important for diagnosis of potentially curable kidney diseases, but also guides the therapy. Patients and methods It was a retrospective observational study conducted to assess the clinical profile and histopathological spectrum in elderly patients who underwent kidney biopsies. Results The most common indication of kidney biopsy was nephrotic syndrome. The commonest histological finding was membranous nephropathy. Compared with the elderly group, the frequency of lupus nephritis, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, and acute tubular necrosis was significantly more in younger age. Conclusions The most common indication for kidney biopsy in the elderly was nephrotic syndrome. Membranous nephropathy was the commonest histologic finding. The results obtained in this study could add to previous studies to give valuable information of kidney diseases in the elderly. Kidney biopsy is useful in diagnosing many treatable kidney diseases in the elderly and prevents unwanted exposure to empirical immunosuppression.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126587449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone markers and renal functional status in healthy Nigeria adults","authors":"A. Ale, Jane Bakare, O. Oyebisi, OL Adeyemo","doi":"10.4103/jesnt.jesnt_40_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_40_21","url":null,"abstract":"Background There is a dearth of reports on the relationship between bone metabolism and renal function in Nigeria. This study determined the association between bone-turnover markers and renal functional status in healthy Nigerian adults. Patients and methods This exploratory observational study consisted of 80 apparently healthy participants aged 22–50 years without known risk factors for renal impairment. Fasting samples were analyzed for biochemical bone-turnover markers, including serum osteocalcin, total alkaline phosphatase, 24-h urine-calcium excretion, parathyroid hormone (PTH), and 25-hydroxyvitamin D [25(OH)D]; and calcium, phosphate, and creatinine. The estimated glomerular-filtration rate (GFR) was calculated using the Cockcroft–Gault formula. Bone mineral density (BMD) was measured by Dual-energy X-ray Absorptiometry scan (DXA scan). Statistical analysis was carried out and P level less than 0.05 was regarded as significant. Results The mean age of study participants was 32.1±5.8 years with a mean GFR of 98.15±9.02 ml/min, mean serum 25(OH)D 51.53±15.45 mmol/l, and mean BMD/Z score 0.54±0.07)/0.20±1.02. None of the participants had osteoporosis or vitamin-D deficiency. There is a significant correlation between bone marker − osteocalcin and BMD, and PTH with BMD and GFR (P<0.05). Also, a nonsignificant trend was observed between calcium excretion, 25(OH)D, and estimated GFR (P=0.07, P=0.08). Conclusion PTH may be an early marker of bone loss in renal dysfunction.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133059343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intradialytic aerobic training on physical performance and quality of life among hemodialysis patients","authors":"H. Elghoneimy, A. El-Deeb, G. Younis, M. Abd El-kader, Hala S El-Wakil","doi":"10.4103/jesnt.jesnt_35_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_35_21","url":null,"abstract":"Background Patients with chronic kidney disease and end-stage kidney disease have reduced physical performance and impaired quality of life. The aim of this work is to study the effect of intradialytic aerobic training using a pedal on physical performance and quality of life among hemodialysis (HD) patients. Patients and methods This experimental study was conducted on 30 adult patients with end-stage kidney disease on maintenance HD for more than 3 months. Mentally or physically unfit patients, patients with overt ischemic heart disease or cardiac decompensation, severe anemic patients (hemoglobin≤8 g/dl), patients with advanced chronic kidney disease-mineral and bone disorder, patients with advanced lower limbs joints disease, and those with amputation of the lower limb were excluded. Patients were divided into two groups; each group consisted of 15 patients. Group A performed intradialytic aerobic exercise for 30 min three times/week for 8 weeks. Group B was a control group. Results There was significant improvement in the distance walked in 6-min walk test in the exercise group (P=0.04). Moreover, there was significant improvement in the main scales of kidney disease quality-of-life short form, version 1.3, Arabic version (Kidney Disease Component Summary, Physical Composite Scale, and Mental Composite Scale) (P<0.001, P=0.018, and P=0.037, respectively). Conclusion Exercise has a beneficial effect on the physical performance and quality of life in HD patients.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130057170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Intradialytic changes in endothelin-1 level and its relation with intradialytic hypertension","authors":"","doi":"10.4103/1110-9165.345442","DOIUrl":"https://doi.org/10.4103/1110-9165.345442","url":null,"abstract":"","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125146099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney transplantation versus dialysis in Zimbabwe: a systematic review of the cost-effectiveness","authors":"M. Obadiah, Sheridan Carl, Halawa Ahmed","doi":"10.4103/jesnt.jesnt_31_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_31_21","url":null,"abstract":"In Zimbabwe, the population of patients with chronic kidney disease is rising, putting a strain on the nation’s few dialysis treatment centers, whether government or private. The government covers the whole expense of delivering dialysis in the government facilities, increasing the financial burden. Patients from both public and private dialysis units opting for kidney transplantation (KT) are referred abroad at high foreign currency costs. The goal of this study focused on reviewing the economic advantage of KT in relation to renal dialysis as a means of establishing a KT program in Zimbabwe. Economic advantage studies on KT versus renal dialysis were obtained using various digital resources. The search strategy was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations. Economic assessment tools such as the Markov model, cost–utility analysis, cost-effective analysis were utilized to substantiate the relevance of KT in improving survival of end-stage renal disease patients at a lower expenditure. In studies where cost-effectiveness between KT and dialysis was compared, it was shown that KT is a cheaper solution with a higher quality of life than dialysis. It was also shown in most of the studies that among the dialysis modalities, hemodialysis (HD) was more expensive than peritoneal dialysis (PD). In one of the studies, the cost values were Euro 36 000 for HD, Euro 26 000 for PD, and Euro 11 000 for KT. The quality-adjusted life years per patient were 0.46 for HD, 0.49 for PD, and 0.61 for KT. As far as cost-effectiveness and raising the health status, wellness level, good living, and survival, KT is rated highly and a better modality than dialysis. It is a more appropriate renal treatment for introduction in Zimbabwe to save on the scarce foreign currency. The barriers to the commencement of KT were identified, and the solutions were enumerated.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122905790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The correlation between hepcidin levels and iron parameters in patients with end-stage renal disease on regular hemodialysis successfully treated from hepatitis C virus by directly acting antiretrovirals","authors":"Magdy El Sharkawy, H. E. El Said, M. Behairy, F. Ahmed, Mohamed Sharaf, L. Khedr","doi":"10.4103/jesnt.jesnt_34_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_34_21","url":null,"abstract":"Background Hepcidin is a polypeptide secreted from the liver. It regulates iron metabolism by blocking further iron absorption when iron stores are high. Hepcidin levels are usually higher than the normal range in hemodialysis (HD) patients. Hepatitis C virus (HCV) infection leads to lowering of hepcidin levels, leading to more iron overload. The objectives were to determine whether there is a correlation between iron stores and hepcidin levels in HD patients after HCV treatment and to assess the level of hepcidin in those patients who were treated from HCV compared with those who have chronic HCV infection. Patients and methods In total, 60 patients on regular HD were recruited and 30 healthy controls . Group I: 30 patients who have been successfully treated from HCV by directly acting antiretroviral drugs with a persistently negative PCR for at least 3 months, group II: 30 patients with chronic HCV infection, and 30 healthy controls form group III. Serum hepcidin levels, iron profile, and complete blood count were compared in all groups. Results Hepcidin levels were significantly higher in the HCV-treated group versus the HCV-infected group (mean 226.77±144.13 and 87.77±40.77 ng/dl), respectively, significantly higher transferrin-binding capacity (TIBC), and mean levels 410.5±74.65 and 310.93±122.57 μg/dl . Ferritin levels were higher in the HCV-infected group (355.13±196, 899.5±1522 ng/dl) than in HCV-treated. There was a significant correlation between hepcidin and serum iron, TIBC, and transferrin saturation in the HCV-treated group. On regression analysis, only TIBC and transferrin saturation correlated significantly. Conclusions Post HCV treatment with directly acting antiretroviral drugs, hepcidin levels are higher than during HCV-infection state and correlate significantly to higher TIBC . Further studies are needed to establish the effect of iron supplementation on hepcidin level in this subgroup of patients.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"70 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123116837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns, triggers, and predictors of relapses among children with steroid-sensitive idiopathic nephrotic syndrome at the University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria","authors":"A. Ademola, Ishola Ibraheem","doi":"10.4103/jesnt.jesnt_36_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_36_21","url":null,"abstract":"Background Childhood steroid-sensitive idiopathic nephrotic syndrome (SSINS) is plagued with relapses that contribute to its morbidity and the cost of treatment. Patients and methods This is a retrospective review of relapses among children with SSINS at the University of Abuja Teaching Hospital from January 2016 to July 2020. Triggers related to relapse incidents were noted. χ2 test was deployed for predictors (factors at the first clinical presentations that associate with subsequent relapses) of relapses. Predictors with P values of less than 0.05 were considered significant, and 95% confidence intervals (CI) and odd ratio (OR) were described. Results A total of 60 patients with SSINS, comprising 52 (86.7%) males, aged 23 months to 18 years, with a mean age of 7.04±4.16 years, were studied. A total of 38 (63.3%) participants had 126 relapses, including infrequent relapses in 30 (78.9%) and frequent relapses in eight (21.1%). The commonest triggers were acute upper respiratory tract infections (68, 53.9%) and urinary tract infections in 25 (19.8%) relapses. In four (3.2%) relapses, no trigger was identified. The time-to-first relapse ranged 14–365 days, with a median time of 60 days. The significant predictors were hypertension (OR=3.4, 95% CI; 1.04–11.09, P=0.038), urinary tract infections (OR=9.9, 95% CI; 1.16–80.71, P=0.014), malaria fever (OR=8.0, 95% CI; 2.45–26.38, P<0.001), microhematuria (OR=4.9, 95% CI; 11.58–15.16, P=0.004), elevated serum creatinine (OR=12.3, 95% CI; 1.48–101.20, P=0.005), and hypercholesterolemia (OR=4.1, 95% CI; 1.35–12.63, P=0.011). Conclusion Although the pathogenesis of relapses remains unknown, it is prudent to consider relapse-specific preventive strategies against triggers and predictors of relapses in our setting.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122065810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of vitamin D3 level in Egyptian hemodialysis patients and the effect of replacement therapy","authors":"A. Sabry, M. Elazazy, Ahmed Mohammed Abd El Wahab","doi":"10.56391/jnrm.2022.1015","DOIUrl":"https://doi.org/10.56391/jnrm.2022.1015","url":null,"abstract":"Background The ability of extrarenal tissues to convert 25-hydroxyvitamin D into 1,25-hydroxyvitamin D and its dependence on substrate levels provide the rationale for supplementing vitamin D in dialysis patients who usually have severe depletion of both calcitriol and vitamin D. The primary aim of the study was to detect serum vitamin D3 levels in a cohort of Egyptian hemodialysis patients and to check the effect of 12-week therapy of cholecalciferol on serum calcium, phosphate, and parathyroid hormone (PTH) in vitamin D-naïve hemodialysis patients with vitamin D deficiency. Patients and methods A total of 40 patients (25 males and 15 females) with chronic kidney disease on regular hemodialysis, attending the Nephrology Unit of internal Medicine Department, Mansoura University Hospital, during the period from January to June 2017, were included. According to laboratory investigations and clinical examination, deficient patients were treated with Devarol-S (cholecalciferol) for 3 months and then revaluated. Deficient patients received intramuscular injection of 50 000 IU monthly for 3 consecutive months. Results The patient group included 40 persons, comprising 27 (73%) male patients and 13 (27%) female patients. Their mean age was 47.16 ± 14.92 years. The mean dialysis duration was 4.68 ± 2.42 years. At 3 months after vitamin D replacement, significant increase in serum calcium (8.33–8.89 mg/dl), phosphorous (4.99–5.85 mg/dl), and vitamin D3 (4.01–28.43 ng/ml) levels were observed compared with pretreatment levels. There was also significant decrease in PTH level (419.30–377.20 pg/ml). After 3 months of follow-up, there were no significant changes in the levels of hemoglobin, Kt/v, albumin, and alkaline phosphatase in the study group. Conclusions In most patients, treatment with cholecalciferol in a 50 000 IU/month dose permits safe correction of vitamin D deficiency and control of PTH level, yet serum phosphorus should be monitored.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"1032 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123667603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}